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The article presents highlights from the AOFAS Annual Meeting 2024, held in Vancouver, Canada, which brought together orthopaedic foot and ankle surgeons and allied health professionals for educational and research advancements.

Background: There is increasing emphasis on assessing resident competency, but little has been published on how to best evaluate trainee competency for ankle arthroscopy. The purpose of this study was to validate an objective model for assessing basic ankle arthroscopy knowledge and operative skills on a cadaveric ankle. Methods: The Diagnostic Ankle Arthroscopy Skills Scoring System was adapted from previously validated assessment tools for knee arthroscopy. The scoring system included (1) an oral questionnaire (0-23 points), (2) an operative task-specific checklist (0-19 points), and (3) a global operative skills rating (12-60 points). Thirty-three trainees consisting of orthopedic residents and medical students performed a diagnostic ankle arthroscopy on a cadaveric ankle and were assessed by a single observer, while a subset were tested by 2 evaluators to determine interobserver reliability. Results: There was strong correlation between educational level and scores on the global operative skills rating scale (r = 0.967, P <.0001), task-specific checklist (r = 0.815, P <.815), and oral questionnaire (r = 0.896, P <.0001). The global operative skills scores significantly improved with training level, and the largest difference was between medical students and senior residents. The most notable year-to-year increases in skill were between postgraduate year (PGY) 1 and 2 (P <.01) and between PGY2 and PGY3 (P <.05). Oral questionnaire and task-specific checklists were significantly lower for medical students than PGY1 residents (P <.001). There was also significant improvement in the oral questionnaire between senior and junior residents (P <.05). There was a moderate correlation between number of self-reported ankle arthroscopy cases and scores on the global operative skills score (r = 0.7019, P <.0001). Interobserver reliability was high for the global operative skills scores (interclass correlation coefficient = 0.89). Conclusion: The study revealed a valid measure to objectively assess trainees' ankle arthroscopy clinical knowledge and operative skills in a bioskills laboratory. Clinical Relevance: This tool should enable residency programs to evaluate competency and track individual trainee progress over time. [ABSTRACT FROM AUTHOR]

The article discusses the importance of utilizing social media platforms for promoting academic publications, emphasizing the potential to reach a large audience, cost-effectiveness, brand identity establishment, audience engagement, and visibility enhancement in the digital age.

Background: The diagnosis of medial ankle instability in Weber B ankle fractures remains controversial. Manual stress and gravity stress radiographs as well as magnetic resonance imaging (MRI) are used, but there is no consensus gold standard. The purpose of this study was to determine the relationship between initial fibular displacement and medial clear space widening on a gravity stress radiograph as a predictor of instability. Methods: A retrospective review was conducted of all patients with isolated Weber B ankle fractures with both initial injury radiographs and gravity stress view from August 1, 2014, through April 1, 2016. A total of 17 patients were identified. On the mortise view of initial injury radiographs, medial clear space (MCS), superior clear space, lateral fibular displacement (LFDP), and fibular shortening (FS) were measured, and on the lateral view, anterior to posterior fibular gap (A to P FG) was measured. MCS was again measured on the gravity stress view (MCS-W). Statistical analyses identified the correlations of each displacement variable relative to MCS-W as well as the sensitivity and specificity of each parameter. Results: A cutoff point for MCS-W was set as less than 5.0 mm (n = 8) and 5.0 mm or more (n = 9). Strong significant correlations with MCS-W were found for A to P FG (0.84, P < .001), with a trend for LFDP (0.62, P = .008), but no significance with FS (0.38, P = .84). Linear regression analysis revealed significant ability to predict MCS-W for both LFDP (P = .002) and A to P FG (P = .001) but not FS. Receiver operating characteristic analysis for A to P FG using a threshold value of 1.0 mm yielded sensitivity and specificity of 100% in predicting an MCS-W of 5.0 mm or more. Conclusion: The initial fibular displacement was a strong predictor of MCS-W in Weber B ankle fractures. On lateral radiographs, an A to P FG greater than 1.0 mm showed a sensitivity and specificity of 100% in predicting an MCS-W of 5.0 mm or more on gravity stress view. [ABSTRACT FROM AUTHOR]

Background: Proximal opening wedge osteotomy (POWO) is an established procedure for moderate to severe hallux valgus. A common concern of this procedure is that it results in lengthening of the first metatarsal, which could cause increased intra-articular pressure of the first metatarsophalangeal joint (MTP) and may ultimately lead to arthritis because of these altered mechanics. The purpose of this study was to use a cadaveric model to compare intra-articular pressures and articulating contact properties of the MTP joint following either scarf osteotomy or POWO. Methods: Fresh-frozen cadaveric below-knee specimens with pre-existing hallux valgus (n = 12) and specimens without hallux valgus (n = 6, control group) were used. The hallux valgus specimens were stratified into 2 groups (n = 6 each): POWO or scarf osteotomy. The groups were matched based on the degree of deformity. Peak intra-articular pressure, force, and area were measured in all normal, preoperative, and postoperative specimens with a simulated weightbearing model. These measurements were made with a pressure transducer placed within the first MTP joint. Results: Postoperatively POWO group had slightly higher contact forces and pressures compared to the scarf group and lower contact forces and pressures than those of the normal group but were not statistically significant (P > .05). Normal specimens had higher intra-articular force, pressure, and area than postoperative specimens but the difference was not found to be significant. First metatarsal lengthening was found in both the scarf and POWO specimens; however, neither increase was found to be significant (P > .05). Conclusion: The results from this study show that after operative correction, contact properties of the fist MTP joint among normal, POWO, and scarf osteotomy groups revealed no significant differences. First MTP joints in those with hallux valgus had significantly lower contact force and pressure compared to those without hallux valgus. Clinical Relevance: With little long-term outcomes of proximal opening wedge osteotomy, this study will help predict the possibility of future MTP joint arthritis. [ABSTRACT FROM AUTHOR]

The article discusses a study which aimed to determine the radiologic results of arthrodesis of the hallux metatarsophalangeal (MP) joint after hallux varus treatment. Topics covered include the results of the measurement and comparison of hallux valgus angle (HVA), the average change in the 1-2 intermetatarsal angle (1-2 IMA), and a the association of hallux MP joint arthrodesis with a predictable increase in the 1-2 IMA.

Competing Interests: The authors do NOT have any potential conflicts of interest for this manuscript.

Purpose: The purposes were to determine the bone density at specific bone tunnel locations in the clavicle and to determine ultimate load to failure of a graft fixed with an interference screw at specific areas., Methods: Bone mass densitometry was tested at 5-mm intervals from the lateral to the medial end of 11 clavicles (mean age, 70.0 ± 17.7 years). Tunnels were drilled in 10-mm increments from the lateral edge, and tenodesis screws were used to fix semitendinosus grafts in the tunnel. Grafts were cyclically loaded, followed by load to failure., Results: The bone mineral density (BMD) of the cadaveric clavicles increased from lateral (0.304 ± 0.078 g/cm(2) at 10 mm) to medial (0.760 ± 0.103 g/cm(2) at 50 mm). Load to failure increased from lateral to medial, and most specimens failed by tendon pullout. The load was 125.3 ± 42.5 N at the most lateral tunnel and 349.3 ± 120.3 N at the most medial tunnel. The Pearson correlation coefficient was 0.653 between tunnel position and load to failure, 0.659 between bone density and load to failure, and 0.803 between tunnel position and bone density. These all showed strong correlation., Conclusions: BMD shows that optimal bone density is found in the anatomic insertion area of the coracoclavicular ligaments between 20 mm and 50 mm from the lateral end of the clavicle. Low BMD correlated with decreased load to failure., Clinical Relevance: Failure at the lateral bone tunnel in coracoclavicular ligament reconstruction may be a result of poor bone quality. When one is drilling bone tunnels for this surgery, consideration should be given to both anatomic position and bone quality., (Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.)